학술논문
Bone health after RRBSO among BRCA1/2 mutation carriers: a population-based study
Document Type
Article
Author
Source
(2022): 1-13.
Subject
Language
Korean
ISSN
20050380
Abstract
Objective: Examine the risks of fractures and osteoporosis after risk-reducing bilateral salpingo-oophorectomy (RRBSO) among women with mutations. Methods: In this retrospective population-based study in British Columbia, Canada, between 1996 to 2017, we compared risks of osteoporosis and fractures among women withmutations who underwent RRBSO before the age of 50 (n=329) with two age-matched groups without known mutations: 1) women who underwent bilateral oophorectomy (BO) (n=3,290); 2) women with intact ovaries who had hysterectomy or salpingectomy (n=3,290). Secondary outcomes were: having dual-energy X-ray absorptiometry (DEXA) scan, and bisphosphonates use. Results: The mean age at RRBSO was 42.4 years (range, 26–49) and the median follow-up for women with mutations was 6.9 years (range, 1.1–19.9). There was no increased hazard of fractures for women with mutations (adjusted hazard ratio [aHR]=0.80; 95% confidence interval [CI]=0.56–1.14 compared to women who had BO; aHR=1.02; 95% CI=0.65–1.61 compared to women with intact ovaries). Among women who had DEXA-scan, those with mutations had higher risk of osteoporosis (aHR=1.60; 95% CI=1.00–2.54 compared to women who had BO; aHR=2.49; 95% CI=1.44–4.28 compared to women with intact ovaries). Women with mutations were more likely to get DEXA-scan than either control groups, but only 46% of them were screened. Of the women withmutations diagnosed with osteoporosis, 36% received bisphosphonates. Conclusion: Women with mutations had higher risk of osteoporosis after RRBSO, but were not at increased risk of fractures during our follow-up. Low rates of DEXA-scan and bisphosphonates use indicate we can improve prevention of bone loss.
Objective: Examine the risks of fractures and osteoporosis after risk-reducing bilateral salpingo-oophorectomy (RRBSO) among women with mutations. Methods: In this retrospective population-based study in British Columbia, Canada, between 1996 to 2017, we compared risks of osteoporosis and fractures among women withmutations who underwent RRBSO before the age of 50 (n=329) with two age-matched groups without known mutations: 1) women who underwent bilateral oophorectomy (BO) (n=3,290); 2) women with intact ovaries who had hysterectomy or salpingectomy (n=3,290). Secondary outcomes were: having dual-energy X-ray absorptiometry (DEXA) scan, and bisphosphonates use. Results: The mean age at RRBSO was 42.4 years (range, 26–49) and the median follow-up for women with mutations was 6.9 years (range, 1.1–19.9). There was no increased hazard of fractures for women with mutations (adjusted hazard ratio [aHR]=0.80; 95% confidence interval [CI]=0.56–1.14 compared to women who had BO; aHR=1.02; 95% CI=0.65–1.61 compared to women with intact ovaries). Among women who had DEXA-scan, those with mutations had higher risk of osteoporosis (aHR=1.60; 95% CI=1.00–2.54 compared to women who had BO; aHR=2.49; 95% CI=1.44–4.28 compared to women with intact ovaries). Women with mutations were more likely to get DEXA-scan than either control groups, but only 46% of them were screened. Of the women withmutations diagnosed with osteoporosis, 36% received bisphosphonates. Conclusion: Women with mutations had higher risk of osteoporosis after RRBSO, but were not at increased risk of fractures during our follow-up. Low rates of DEXA-scan and bisphosphonates use indicate we can improve prevention of bone loss.
Objective: Examine the risks of fractures and osteoporosis after risk-reducing bilateral salpingo-oophorectomy (RRBSO) among women with mutations. Methods: In this retrospective population-based study in British Columbia, Canada, between 1996 to 2017, we compared risks of osteoporosis and fractures among women withmutations who underwent RRBSO before the age of 50 (n=329) with two age-matched groups without known mutations: 1) women who underwent bilateral oophorectomy (BO) (n=3,290); 2) women with intact ovaries who had hysterectomy or salpingectomy (n=3,290). Secondary outcomes were: having dual-energy X-ray absorptiometry (DEXA) scan, and bisphosphonates use. Results: The mean age at RRBSO was 42.4 years (range, 26–49) and the median follow-up for women with mutations was 6.9 years (range, 1.1–19.9). There was no increased hazard of fractures for women with mutations (adjusted hazard ratio [aHR]=0.80; 95% confidence interval [CI]=0.56–1.14 compared to women who had BO; aHR=1.02; 95% CI=0.65–1.61 compared to women with intact ovaries). Among women who had DEXA-scan, those with mutations had higher risk of osteoporosis (aHR=1.60; 95% CI=1.00–2.54 compared to women who had BO; aHR=2.49; 95% CI=1.44–4.28 compared to women with intact ovaries). Women with mutations were more likely to get DEXA-scan than either control groups, but only 46% of them were screened. Of the women withmutations diagnosed with osteoporosis, 36% received bisphosphonates. Conclusion: Women with mutations had higher risk of osteoporosis after RRBSO, but were not at increased risk of fractures during our follow-up. Low rates of DEXA-scan and bisphosphonates use indicate we can improve prevention of bone loss.